Kornimate/medical-research-clean huggingface dataset:
the therapeutic evaluation(both short-term and long-term outcome) of minimal invasive radical antegrade modular pancreatosplenectomy for left-sided pancreatic cancer patients

Conditions: Pancreatic Cancer; Surgery

Summary: pancreatic cancer is regarded as "the king of cancer". it is extremely malignant, with a low sensibility to chemotherapy and radiotherapy, and a poor prognosis. surgical treatment is very important for pancreatic cancer. radical antegrade modular pancreatosplenectomy (ramps) is a standard method for treating pancreatic cancer at the body and tail of pancreas. in the same surgical approach, the investigators are going to compare and discuss the advantages of laparoscopic and open ramps in the rct study.

open ramps is widely used now to treat pancreatic cancer at the body and tail of pancreas. meanwhile, laparoscopic surgery is proved to have many advantages in other operations. according to primary retrospective study of open and laparoscopic ramps, there was no statistically significant difference in the long-term follow-up situations between these two groups, indicating the safety of both this two surgical approaches. the investigators would like to promote a prospective rct study, to give more evidences of the superiority of laparoscopic ramps.

Eligibility criteria:
inclusion criteria: 1. 18 years old and older; 2. pathology diagnosed as pancreatic adenocarcinoma or suspect cancer mass at the pancreatic body or tail; 3. patients who are eligible and planned to be performed ramps procedure; 4. resectable or borderline resectable tumor by preoperative evaluation. exclusion criteria: 1. patients with evidence of distant metastasis or advanced arterial invasion so that are not able to continue radical surgery; 2. asa≥4； 3. patients who are not willing to be performed open and/or mi-ramps; 4. not pancreatic adenocarcinoma by posteroperative pathology.

Keywords: radical antegrade modular pancreatosplenectomy(ramps) pancreatic cancer minimal invasive eras disease free survival
paclitaxel (albumin-bound) combined with radiotherapy for the treatment of early stage nasopharyngeal carcinoma

Conditions: Nasopharyngeal Carcinoma

Summary: this trial is a prospective, parallel controlled, randomized, open, multi-center phase iii clinical trial. the trial will enroll 364 patients with nasopharyngeal carcinoma who are staged t1-2n0-1m0 (except t1n0m0) (uicc 8th edition) . this experiment was participated by multiple centers of nanjing gulou hospital, jiangsu provincial people's hospital, jiangsu cancer hospital, nanjing military region general hospital, jiangsu provincial hospital of traditional chinese medicine, and zhongda hospital. each center competes for admission of cases. the subjects will be randomly assigned (using the random number table method according to the order of entry) to the experimental group to receive albumin-bound paclitaxel combined with imrt concurrent radiotherapy, or the control group to receive cisplatin combined with imrt concurrent radiotherapy.


Eligibility criteria:
inclusion criteria: * differentiated non-keratinizing carcinoma and undifferentiated non-keratinizing carcinoma confirmed by pathology; * the staging is t1-2n0-1m0 (except t1n0m0) (uicc 8th edition); * initial treatment patients who have not received anti-tumor therapy; * no history of other malignant tumors; * male or female, aged 18 to 70 years old; * liver and kidney function: total bilirubin ≤ upper limit of normal (uln); ast and alt ≤ 2.5 times uln; alkaline phosphatase ≤ 5 times uln; creatinine clearance ≥ 80 ml/min; * neutrophil count (anc) ≥2×109/l, platelet count ≥100×109/l and hemoglobin ≥9 g/dl; * no serious heart, lung, liver, kidney and other important organ dysfunction; * karnofsky score ≥70 points; * sign the informed consent form; * able to follow research protocols and follow-up procedures. exclusion criteria: * anti-tumor treatment has been performed, including chemotherapy, radiotherapy, and surgery; * find distant metastases before treatment; * women who are pregnant or breastfeeding; * disagree to sign the informed consent form; * patients who cannot cooperate with regular follow-up due to psychological, social, family and geographic reasons; * simultaneously accept experimental treatment of other clinical research (in the treatment period of clinical research); * known to be allergic to possible chemotherapy drugs; * patients with other malignant tumors; * accompanied by severe uncontrollable infections or medical diseases, including autoimmune diseases; * major organ dysfunction, such as decompensated heart, lung, kidney, and liver failure, cannot tolerate radiotherapy and chemotherapy; * laboratory examination: total bilirubin\>upper limit of normal (uln); ast and/or alt\>1.5 times uln and accompanied by alkaline phosphatase\>2.5 times uln; * any uncertain factors that affect patient safety or compliance.
neuropsychological functioning and cerebral perfusion post carotid endarterectomy

Conditions: Carotid Artery Stenosis

Summary: the study aims to investigate the relationship between neuropsychological functioning and brain perfusion in patients undergoing carotid endarterectomy and control patients undergoing other peripheral vascular procedures.

carotid endarterectomy (cea) is a vascular surgical procedure that is aimed at reducing accumulated cholesterol and fats in carotid arteries. while some research indicates that cea is associated with improvements in neuropsychological functioning, other studies have identified deficits in neuropsychological functioning following cea. the factors associated with these different outcomes are unclear. identification of the factors that mediate post-cea neuropsychological functioning outcomes may allow for the development of interventions that would improve such outcomes. recent research has identified a relationship between post-cea neuropsychological deficits, and cerebral blood flow in certain areas of the brain, with some indication that brain cell loss following cea may be a key factor. the proposed study will explore changes in cerebral blood flow through the use of diffusion-weighted magnetic resonance images (dw-mri) to investigate the relationship between neuropsychological functioning and brain perfusion in 70 cea patients and to compare neuropsychological functioning of the cea patients to a control group of 30 patients undergoing other peripheral vascular surgical procedures. patients' neuropsychological functioning will be assessed pre, post and six months after the cea or peripheral vascular surgery. additionally dw-mri will be assessed pre and post surgery for the patients undergoing cea.

Eligibility criteria:
inclusion criteria: * patients undergoing elective carotid endarterectomy or other peripheral vascular surgical procedures. * ages 40-90 exclusion criteria: 1. history of substance use: history of cocaine use within the past 12 months. tetrahydrocannabinol use within the past 12 months. 2. conditions that affect brain mri/contraindications for mri: diagnosis of hiv. history of any traumatic brain injury. history or current diagnosis with any form of brain tumor. current normal pressure hydrocephalus. patients with any implanted metallic medical device, or non-removable metallic material in their body 3. conditions that affect neuropsychological assessment: diagnosis with attention deficit/hyperactivity disorder. current major depressive episode. current manic episode. current psychotic episode. diagnosis with any developmental disorder. diagnosis with any form of dementia (mmse\<24). a score higher than 3 on the modified rankin scale indicating a major stroke. 4. general contraindications: diagnosis with or history of any medical condition that, based on reasonable clinical judgment, would clinically contraindicate the patient undergoing any of the study procedures.

Keywords: carotid endarterectomy neurocognitive functioning cerebral perfusion
prospectively assessing pain after breast surgery

Conditions: Pain, Postoperative

Summary: reducing post-operative pain and reducing the use of opioid narcotics are independently valuable goals. before studying newer techniques that may help us achieve these goals, we need objective data on how much pain normally occurs after breast surgery done with standard-of-care techniques. this study was designed to obtain baseline data.

breast surgeons may be able to reduce post-operative pain and the need for opioid narcotics by utilizing regional anesthesia techniques (modified regional blocks) during surgery. to test this hypothesis, we need baseline (pre-intervention) data on how much pain patients experience when breast surgery is done without blocks. in this study, we will gather data on (1.) pain pills used after surgery, and (2.) pain scores in the recovery room. this will allow us to establish how much pain normally occurs after axillary surgery (sentinel node biopsy or axillary dissection), with or without concurrent lumpectomy, done by a participating breast surgeon. after analyzing this data, our plan is to do a second study, with a new group of patients, to assess whether there is any change in outcome after surgeons implement these new techniques.

Eligibility criteria:
inclusion criteria: 1. provision of signed and dated informed consent form. 2. stated willingness to comply with all study procedures and availability for the duration of the study. 3. female, age 18 or older. 4. scheduled for axillary surgery (sentinel node biopsy or axillary dissection), with or without concurrent lumpectomy. 5. able to take oral narcotics and be willing to adhere to the prescribed regimen. exclusion criteria: 1. a history of chronic pain 2. any previously diagnosed chronic pain syndrome. 3. prior use of narcotics, on more than 5 days in the past 3 months or 10 days in the past year.
xrai - improving quality and efficiency in chest radiograph interpretation by radiologists

Conditions: Pulmonary Disease

Summary: xrai (pronounced "x-ray") serves as a clinical assistance tool for trained clinical professionals who are interpreting chest radiographs. the tool is designed as a quality control and adjunct, limited, clinical decision support tool, and does not replace the role of clinical professionals. it highlights areas on chest radiographs for review by an interpreting clinician. the objective of this study is to utilize machine learning and artificial intelligence algorithms (xrai) to improve the quality and efficiency in the interpretation of chest radiographs by radiologists. the hypothesis is that the addition of xrai's analysis will reduce inter-observer variability in the interpretation of chest radiographs and increase participants' sensitivity, recall, and accuracy in pulmonary abnormality screening.

to investigate the effect of xrai for radiologists that interpret chest radiographs as part of their daily responsibilities, the investigators have designed a randomized control trial. the pulmonary abnormalities detected by xrai and included in the definition of abnormal are as follows: any linear scar or fibrosis, atelectasis, consolidation, abscess or cavity, nodule, pleural effusion, severe cases of emphysema and copd (mild cases with hyperinflation but not significant emphysema are not flagged), and pneumothorax. to assess the causal effect of xrai the investigators randomly assign 10 to 14 radiologists to either treatment (x-ray images processed by xrai) or control (no xrai processing) groups. participants will only review images once. each participant will perform 500 radiograph interpretations in total. participants in the control group will be asked to interpret the same 500 images without xrai's analysis. to increase the precision of the estimate and better investigate potential differences between clinical professionals, investigators block randomize the assignment of treatment or control group. to analyse the effect of xrai, the investigators will estimate the average treatment effect (ate) for each group by comparing the performance of the treatment and control groups using randomization-based inference (green and gerber, 2012).

Eligibility criteria:
inclusion criteria: * radiologist currently practicing at a pureform radiology clinic in calgary, canada. exclusion criteria: * radiologists not currently practicing at a pureform radiology clinic in calgary, canada. * physicians currently practicing at a pureform radiology clinic in calgary, canada, but that are not radiologists by training.
musculoskeletal ultrasound study in critical care: longitudinal evaluation

Conditions: Critical Illness; Septic Shock; Trauma; Organ Failure

Summary: each year, 110,000 english/welsh patients are admitted to intensive care units (icu). many face prolonged disability as a result. over two thirds have moderate-extreme limitation in their usual activity a year later, and one-third are severely affected, being unable to continue "most activities," or to live independently. quite why known- but severe muscle wasting isn't may play an important role. we hope to find out, measuring the degree of wasting in patients, and seeking potential causes. we shall also address the mechanism of wasting, which may reflect an altered balance of activity in muscle growth pathways and those that break muscle down. we'll do this by collecting data, taking regular blood tests, scanning the leg muscles with an ultrasound machine, and analysing small muscle samples. in addition, we'll accurately and objectively measure how impaired these patients become, using specialist questionnaires, special monitoring equipment, simple walking tests and occasional special ('cardio-pulmonary') exercise tests. we'll try to see how badly activity is limited, and tease out whether muscle weakness plays a significant role in this. finally, keeping muscles working (hard to do when unconscious/drowsy/bed-bound) may maintain muscle mass, so we'll see whether maintaining muscle activity using painless electrical stimulation will help.


Eligibility criteria:
inclusion criteria: * ventilated patients aged \> 18 years likely to survive and remain ventilated for 48 hours and on icu for 7 days will be recruited. exclusion criteria: * those who are pregnant, * have active malignancy, * have primary muscle/bilateral lower limb disorders or * are unlikely to survive 48 hrs.
comparison of trifecta analysis of standard versus mini percutaneous nephrolithotomy in the management of urolithiasis

Conditions: Renal Stones; Urolithiasis, Calcium Oxalate

Summary: introduction: urolithiasis is a common urological condition, and percutaneous nephrolithotomy (pcnl) is a widely used treatment option. trifecta analysis, which includes stone-free rate, reduced complications (clavien- dindo classification), and minimal need for auxiliary procedures, provides a standardized way to compare outcomes. this study evaluates the trifecta outcomes of standard pcnl and mini pcnl.

methodology: this prospective cohort study was conducted at the department of urology, institute of kidney diseases, peshawar from jan 2022 to march 2024. 180 consecutive individuals who were subjected to percutaneous nephrolithotomy (pcnl) were registered for the study. patients were randomly assigned into two equal groups using a lottery method. both the standard pcnl group and mini pcnl group consisted of 90 patients each. patients who required a change in the planned surgical procedure were replaced with new participants from the sample frame. a structured proforma was filled out for all preoperative, perioperative, and postoperative variables in administration of trifecta, and the data was analyzed using spss. an assessment was done for predictive factors for the trifecta using logistic regression to calculate the odds ratio, confidence interval (ci), and p value.

Eligibility criteria:
inclusion criteria: * patients aged between 16 and 65 years having renal stones exceeding 20 mm in diameter or having a density more than 1000 hounsfield units (hu) were included. exclusion criteria: * patients with residual stones following prior pcnl or other endourological procedures or active, untreated urinary tract infections or sepsis or patients with deranged coagulation profiles, were excluded

Keywords: renal stone pcnl
therapeutic effect of new biologics in crohn's disease

Conditions: Inflammatory Bowel Diseases; Crohn Disease; Ulcerative Colitis; Treatment Side Effects

Summary: new types of biologics have brought advantages in therapy strategies for crohn's disease. however, clinical data evaluating their efficacy and adverse in china is lacking. we aimed to evaluate the short-term and long-term therapeutic effect as well as drug adverse of ustekinumab (ust) and vedolizumab (ved). besides, we aim to figure out the independent factors predicting the effectiveness of new biologics. relations between drug exposure (trough concentration and antibody concentration) and therapeutic efficacy are study in-depth by this retrospective observational study.


Eligibility criteria:
inclusion criteria: * consecutive adult patients with confirmed diagnosis of crohn's disease and administration of new type biologics. exclusion criteria: * loss of follow-up, incomplete clinical data, without confirmed diagnosis
integrating mindfulness into the patient-centered medical home (phase 2)

Conditions: Depression; Anxiety; Stress Related Disorder; Adjustment Disorders

Summary: among primary care patients, compare the effectiveness of an 8-week mindfulness-based intervention (mindfulness training for primary care\[mtpc\]) vs. a low-dose mindfulness introduction comparator on self-management of chronic illness and illness-related health behavior action plan initiation, as well as on measures related to anxiety, depression, and stress.

this study builds on a pilot study that investigated the impact of mindfulness training for primary care on anxiety, depression, stress, and chronic illness self-management in primary care patients receiving care in an urban, community, multi-cultural safety net healthcare system. the current comparative effectiveness randomized controlled trial takes place in a larger sample, and investigates the impact of a refined mtpc curriculum on specific aspects of self-regulation such as action plan initiation, while examining potential mechanisms of change, including self-efficacy, perceived control, mindfulness, self-compassion, emotion regulation, and body awareness. participants randomized to mtpc are compared with participants who are randomized to a low-dose comparator condition and receive a 1-hour introduction to mindfulness with a referral to community mindfulness resources. outcome assessments are conducted at baseline and study weeks 8-10.

Eligibility criteria:
inclusion criteria: * current cha patient with an enrolled cha primary care doctor. * cha patients 18 years of age and older. * able to tolerate and participate in interviews and engage in all procedures. * able to give written consent in english or willing and able to provide consent and complete assessments through a professional language translator when necessary. * diagnosis eligible to be covered by insurance for group visits (e.g., anxiety disorder, depression, or adjustment disorder related to chronic illness, pain, etc.). exclusion criteria: * any cognitive impairment that precludes informed consent. * patients who, in the opinion of the principal investigator, pose an imminent risk of suicide or danger to self or others. * likelihood of potential incarceration such as a conviction or pending charges that may potentially result in imprisonment. * previous enrollment or randomization of treatment in the present study within the 12 months. * behaviors that may cause disruption to a mindfulness group. * patients with symptoms of psychosis, thought disorder, and/or severe mental illness, including schizophrenia, schizoaffective, bipolar disorder, or a current severe episode of major depressive disorder. * lack of insurance coverage for group psychotherapy may preclude participation in groups. * patients in their third trimester of pregnancy who foresee conflicts that preclude their commitment to completing all activities. * patients with highly unstable medical problems that put them at a high risk of hospitalization.
in vivo ncle study in the pancreas with endosonography of cystic tumors

Conditions: Pancreatic Cysts

Summary: assess the safety and efficacy of the cellvizio needle-based confocal laser endomicroscopy (ncle) system in differentiating benign from malignant and premalignant cysts (e.g. mucinous from non-mucinous cysts)

the primary aim of the study is to define interpretation criteria to differentiate mucinous from non-mucinous cysts and classify more precisely the cysts. once these criteria have been defined, the diagnostic parameters of ncle in differentiating the different types of cysts and the reproducibility of these criteria will be assessed.

Eligibility criteria:
inclusion criteria: * patients scheduled for an eusfna procedure of a pancreatic cyst, * patients aged 18 years or older, * patients is under surgical consideration for management of the cyst * patients have provided written informed consent for the study exclusion criteria: * allergy to fluorescein * pregnancy or breast-feeding

Keywords: pancreatic cysts
pharmacokinetics/pharmacodynamics (pk/pd) of caspofungin in intensive care unit (icu) patients. an open observational study for antifungal treatment's optimization

Conditions: Critical Illness; Infection

Summary: pk of caspofungin in icu septic patients might be changed as compared to healthy volunteers due to sepsis-related pathophysiology. sub-optimal plasma and tissue concentrations might be achieved in these patients when drugs are administered at the same dosage/regimen suggested for healthy volunteers.

open non randomized, non controlled single center study on the pharmacokinetics of caspofungin in 20 consecutive icu patients with severe sepsis or septic shock, requiring caspofungin therapy and pk-pd evaluation for the optimization of caspofungin therapy. the aim of this study is to describe the caspofungin pk-pd alterations in a cohort of critically ill septic patients.

Eligibility criteria:
inclusion criteria: * adult icu patients (\>18 yrs) * severe sepsis or septic shock * caspofungin therapy based on clinical judgement (empiric therapy) or microbiological result (targeted therapy). exclusion criteria: * concomitant ciclosporin or rifampicin therapy. * pregnancy * continuous renal replacement therapy * severe liver failure (child pugh score \> 6)

Keywords: caspofungin pharmacokinetic pharmacodynamic
minimally invasive vestibular neurectomy versus tenotomy of the stapedius and tensor tympani muscles in the management of patients with unilateral meniere's disease

Conditions: Ménière

Summary: the distinctive symptoms of meniere's disease (md) include recurrent vertigo spells, fluctuating hearing loss, aural fullness and tinnitus. conservative treatment in md comprises lifestyle modifications, such as low-sodium diet, avoidance of caffeine, alcohol and stress, in addition to medication such as diuretics and betahistine. when conservative treatment fails, surgical management is attempted. surgical interventions comprise transtympanic steroids or gentamicin, endolymphatic sac surgery (es), ventilation tube placement, vestibular neurectomy, and labyrinthectomy. recently, loader et al. have presented encouraging results of the effectiveness of tenotomy of the stapedius and tensor tympani muscles (tstm) in the management of patients with definite md. also, satisfactory results were obtained with endoscopic assisted minimally invasive vestibular neurectomy (mivn). the aim of this study is to compare the clinical outcomes of md patients who were submitted to either mivn or tstm in our department.


Eligibility criteria:
inclusion criteria: * unilateral definite meniere's disease. exclusion criteria: * other peripheral or central vestibular disorders, bilateral md and neurologic disorders. * previous history of chronic otitis media or middle ear surgery.